Provider Demographics
NPI:1508902453
Name:BYRD, JAMES ANDREW (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANDREW
Last Name:BYRD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 CAROL LN
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2235
Mailing Address - Country:US
Mailing Address - Phone:817-295-2877
Mailing Address - Fax:
Practice Address - Street 1:4710 MERCANTILE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-3605
Practice Address - Country:US
Practice Address - Phone:817-547-1000
Practice Address - Fax:817-547-1049
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist